My new boss is an accountant, or is it a banker. I never know the difference. He can be as well a butcher and it would make little difference. They’re all the same; a bunch of hard- driven, well paid, well-dressed ball busters (apart from the butchers, of course). Point is, they’re non-medics. They eat soil and shit stones (Ok, that’s not them, that was from a vampire movie). But you get my point!
For someone with his head tightly riveted up medicine’s somber ass, most of what goes on outside of colostomies, pre-eclampsia and schizophrenia is just a dark and shadowy hole.  I never understand much of what everyone else’s job involves. It always seems very intangible, undefined, and maybe even chaotic. Yet folks seem to thrive in this chaos. Their success is not about how many years of experience you have but how far you’re willing to push beyond the limits, how tight you’re willing to grab the bull by the balls.  A million bucks is made in in a heartbeat and lost in two. For someone like me, this shit is scary.  It’s as scary as waking up naked in Greece!
Here’s the reason why it’s scary for me – I see medicine as an unchanging profession. What you and I do is more or less similar to what Hippocrates and other physicians of his generation did. Our patients have more or less the same ailments. Other than the extinction of smallpox and the fact that gonorrhea is less of a shame nowadays, the disease spectrum hasn’t changed much.  Malaria is as much of a mystery and syphilis is as debilitating as it has always been. It’s the same old surgical procedure of disemboweling a poor man and chopping off his appendix, invented by surgeons of the peri-Hippocratic era that we still continue to practice. The anesthesia has become less inhuman compared to the customary chock hold, the surgical equipment are a bit less rusty (most of the time), and we have way more Medreps nowadays, but other than such minor adjustments, things are pretty much the same.  Even the doctors dressing hasn’t changed much!
Medicine, in our setting, has become heavily reliant on precedence, with little emphasis on creativity. We are taught to follow rules. It’s a trade that has grown to shun outliers. The eccentrics have become isolated, and the conformists rule the day. We are taught to guard our words lest we say something shameful and unintelligent. With time, we learn to guard our thoughts as well. The insightful and eccentric thoughts are replaced by banality. We develop a dangerous aversion to risks and to pursuits that are unconventional. Other than handful of men, the medical fraternity’s representation in corporate circles is conspicuous in its absence. That’s why Mafia House is awash with all sorts of miseducated fools, intellectual derelicts crawling out of the woodwork from all joints. The clinical departments are bedfellows with private sector cartels;  research departments are headed by individuals with the least shred of innovation. End result – poor patients languish in sickness and hungry young doctors on overdrive spending  sleepless nights doing lowly paid locums while waiting for the big break.
Maybe it’s not all too bad that we have one of those, ball-squeezing, boardroom bullies.  Maybe it’s time to shake things up a little.  Time to shift gear.  The Kenyan healthcare infrastructure is a system on its knees.  A tattered, dysfunctional, everyone-for-himself rat race. Maybe the accountant/banker/butcher is the man for the job. Maybe he’ll offer some fresh thought. On the bright side, if he lets us down, we can always have him on chock hold and do a reverse- orchidepexy, sans anesthesia!